In this article, the main amphistome species infecting domestic and wild ruminants in East and Southern Africa, their snail intermediate hosts and epidemiological features are reviewed and discussed. Twenty-six amphistome species belonging to nine genera from three families occur in domestic and wild ruminants in the region under review and over 70% of them belong to the genera Calicophoron, Carmyerius and Cotylophoron. Of the amphistome species, 76.9% are shared between domestic and wild ruminant hosts – an important observation when considering the different options for control. Seven freshwater snail species belonging to four genera from two families act as intermediate hosts of the identified amphistome species, with the genus Bulinus contributing 57% of the snail species. Some of the snails are intermediate hosts of amphistome species belonging to the same genus or to different genera; a phenomenon not yet fully elucidated as some snails are reported to be naturally infected with amphistome cercariae of unidentified species. Only nine (34.6%, 9/26) of the amphistome species have known snail intermediate hosts, while most (65.4%, 17/26) have unknown hosts. Species of intermediate hosts and the potential of the flukes to infect these hosts, the biological potential of the snail hosts, the definitive hosts management systems and their grazing habits are considered to be the main factors influencing the epidemiology of amphistomosis. Based on the epidemiological features of amphistome infections, various practical control options are discussed. Further research is necessary to determine amphistome–snail associations, develop diagnostic tests that can detect prepatent infections in the definitive host, determine the burden and economic importance of amphistomosis in domestic and wild ruminants and the efficacy of different anthelmintics in the treatment of patent infections.